title: Biomechanics of the heel-raise test performed on an incline in two knee flexion positions.
abstract: BACKGROUND
  Although single-legged heel-raise cycles are often performed on an incline in different knee flexion positions to discriminate the relative contribution of the triceps surae muscles, detailed kinematic and kinetic analyses of this procedure are not available. Our study characterizes and compares the biomechanics and clinical outcomes of single-legged heel-raise cycles performed to volitional exhaustion on an incline with the knee straight (0°) and bent (45°), considering the effect of sex and age.
  
  
  METHODS
  Fifty-six male and female volunteers, with equal numbers of younger (20 to 40 years of age) and older (40 to 60 years of age) individuals, completed a maximal number of heel-raise cycles on an incline at both nominal knee angles. Kinematic and kinetic data were acquired during testing using a 3D motion capturing system and multi-axial force plate. The impact of fatigue on performance was quantified using changes in maximal voluntary isometric contraction force and biomechanical performance of cycles.
  
  
  RESULTS
  Overall, participants completed three more cycles and maintained better biomechanical performance with 45° than 0° of knee flexion. More precisely, the decreases in maximal heel-raise heights, plantar-flexion angles at maximal height and ranges of ankle motion per cycle were all smaller with the knee bent. However, several outcomes indicated similar plantar-flexion fatigue at both knee angles. Males demonstrated a more rapid decline in peak ground reaction forces during testing; but otherwise, neither sex nor age significantly impacted outcomes.
  
  
  CONCLUSIONS
  It is concluded that the differences discerned here in the biomechanics of single-legged heel-raise cycles performed at 0° and 45° of knee flexion to volitional exhaustion on an incline may be too small to identify in clinical settings or reflect substantial alterations in the relative contribution of the triceps surae muscles.
authors.affiliation: Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Kunskapens väg 8, Hus D, 83125 Östersund, Sweden. kim.hebert-losier@miun.se
authors.forename: Kim
authors.initials: K
authors.lastname: Hébert-Losier
authors.forename: Hans-Christer
authors.initials: HC
authors.lastname: Holmberg
mesh_terms: D000328:Adult; D000843:Ankle Joint / Q000502:physiology; D001696:Biomechanical Phenomena; D005260:Female; D006365:Heel / Q000502:physiology*; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology*; D007700:Kinetics; D007719:Knee Joint / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D018763:Muscle Fatigue / Q000502:physiology; D018482:Muscle, Skeletal / Q000502:physiology*; D010807:Physical Endurance / Q000502:physiology; D012044:Regression Analysis
keywords: Clinical test; Endurance; Fatigue; Plantar-flexion; Triceps surae muscles